Individual provider Active NPI

Jasmine M Kaylor

  • Professional Counselor
  • Decatur, IL
National Provider Identifier
1053934471
Registry record updated Oct 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
180017474 Issued in IL
Practice address
151 N Main St
Decatur, IL 62523-1206
Phone
(217) 420-4776
Fax
(217) 362-6290
NPI assigned
May 20, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 180017474 IL Primary
Counselor 101Y00000X 178-015207 IL

Addresses

Primary practice location

151 N Main St
Decatur, IL 62523-1206

Mailing address

151 N Main St
Decatur, IL 62523-1206
Phone (217) 420-4776

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240212001097 IL Practitioner - Mental Health Counselor 9931542545 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
178-015207ILMDCounselor
180017474ILMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Heritage Behavioral Health Center CurrentSince Jan 6, 2026 Accepting new patients
Heritage Behavioral Health Center Past Accepting new patients
Heritage Behavioral Health Center Inc. Past Accepting new patients
Heritage Behavioral Health Center Inc. Past Accepting new patients
Heritage Behavioral Health Center, Inc. Past Accepting new patients
Heritage Behavioral Health Center Past Accepting new patients
Heritage Behavioral Health Center Inc. Past Accepting new patients
Heritage Behavioral Health Center, Inc Past Accepting new patients
Heritage Behavioral Health Center Past Accepting new patients
Heritage Behavioral Health Center, Inc Past Accepting new patients

Locations

140 Sunrise Ct
Clinton, IL 61727
Phone (217) 570-0900

2965 N Main St
Decatur, IL 62526
Phone (217) 464-1250

151 N Main St
Decatur, IL 62523
Phone (217) 420-4776

243 W Cerro Gordo St
Decatur, IL 62522
Phone (217) 422-3940

788 E Clay St
Decatur, IL 62521

Organizations & group practices 11

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1589932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761091200000",
    "number": "1053934471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "151 N MAIN ST",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625231206",
            "telephone_number": "217-420-4776",
            "fax_number": "217-362-6290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "151 N MAIN ST",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625231206",
            "telephone_number": "217-420-4776",
            "fax_number": "217-362-6290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAYLOR",
        "first_name": "JASMINE",
        "middle_name": "M",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-20",
        "last_updated": "2025-10-22",
        "certification_date": "2025-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180017474",
            "primary": true
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "IL",
            "license": "178-015207",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, IL

Sources for this page

Verify at the official NPI Registry.